The Clinical Features、Sleep Quality And The Sleep Structure Changes Of The Patients With Primary Restless Legs Syndrome

Objective：In this article,we will focus on the sleep quality and the sleep structure changesof the patients with primary restless legs syndrome,and offer the objective basis forpreventing and treating restless legs syndrome.Methods：We summarized general characteristics of all selected patients with confirmedprimary restless legs syndrome, using International Restless Legs Syndrome Scale(IRLSS), Pittsburgh Sleep Quality Index(PSQI) and Epworth Sleepiness Scale (ESSto rate their severeness of clinical syndrome, sleep quality and daily functions.Meanwhile we used Polysomnogram (PSG) to monitor the changes of their sleepstructure. For the normal group we selected healthy people through clinical matching.Results：In this research,there were14patients with primary restless legs syndrome,3ofthem reporting single-leg malaise (accounting for21.43%),10reporting double-legmalaise (71.43%) and only1reporting malaise of other body parts (7.14%).12ofthem (85.71%) were hit by the syndrome frequently and the other2were occasionallyhit (14.29%).13patients (92.86%) took more than half a year to get the RLSconfirmed since its first attack.12patients(85.71%) reported poor sleeping.1. Rating results of IRLSS:2cases of mild syndrome (14.29%),9cases ofmoderate syndrome (64.29%),3cases of severe syndrome (21.43%) and0case ofextremely severe syndrome (0.00%).2. Rating results of PSQI: average PSQI score of RLS group was6.64±2.41,obviously higher than the normal group’s average PSQI score of3.58±2.19(P<0.05).Number of persons with higher-than-7PSQI scores in the RLS group was8, and oneperson in the normal group had a higher-than-7PSQI score. The difference here hadstatistical significance (P<0.05).The sleep quality of RLS group is worse than thenormal group,especially in terms of sleep latency (P<0.05) and sleep quality (P <0.05). The more severe the RLS is, the higher the PSQI score is, representing poorer sleep quality (P<0.05), longer sleep latency (P <0.05) and shorter sleep duration (P <0.05).3. Rating results of ESS: in RLS group, there were4cases (28.57%) whose ESSscores were equal to or more than10; while in the normal group there was only onesuch case(8.33%). However, the difference had no obvious statistical significance(P>0.05). The average ESS score for mild RLS group was4.00±2.83, for moderateRLS group it was6.89±3.33and for severe RLS group it was5.33±4.04. Inter-groupdifferences had no statistical significance (P>0.05).4. After analyzing the PSG results between the RLS group and the normal group,we found that compared with the normal group,the sleep structure of RLS groupchanged, mainly in such aspects as the reduction of total sleep duration (P<0.05), thedecrease of sleep efficiency (P<0.05), the increased arousals (P<0.05) and higher legmovement index (P<0.05). Moreover, the more severe the RLS is, the more changesthe sleep structure would have, especially in term of total sleep duration (P<0.05),sleep efficiency (P<0.05) and leg movement index (P<0.05).5. Status of co-morbid PLMS: There were9cases (64.29%) combined withPLMS in RLS group and3cases (25.00%)in normal group. The index of legmovement in RLS group was37.92±38.36, higher than that of9.71±8.90(P<0.05) inthe normal group. In RLS group, the ratios of leg movement appearing in each termwere:(57.06±20.63)%in awaking period (the highest), followed by (24.09±17.49)%in N1period,(13.90±8.54)%in N2period,(1.69±2.34)%in N3period and(3.26±5.45)%in REM period.Conclusion：In this study,we found that the sleep quality of patients with primary restless legsyndrome is obviously worse than healthy people. And the more severe the RLS is,the worse the sleep quality is, especially in terms of sleep latency, sleep quality andtotal sleep duration. Moreover, the sleep structure also will have such changes as lowsleep efficiency, reduced total sleep duration, poor continuity of sleep and morevulnerable to arousals. The more severe the RLS is, the more obvious the changes ofsleep structure will have. Some patients will be affected of their work and study thenext day because of poor sleep. The RLS mainly appears in awaking period. During sleep the syndrome mainly happens in N1and N2period. N3period and REM periodseldomly see such syndrome.As primary RSL mainly has a bad effect on patientsfalling asleep, dopamine receptor agonists or non-benzodiazepines drugs can be usedto address the difficulties of patients falling asleep and improve their life quality.